Individual
RONALD JEAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
AT
Contact information
Practice address
514 JOYCE ST, ORANGE, NJ 07050-1411
(973) 672-2214
(973) 672-1320
Mailing address
514 JOYCE ST, ORANGE, NJ 07050-1411
(973) 672-2214
(973) 672-1320
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
25MT00135200
NJ
Other
Enumeration date
06/10/2010
Last updated
06/10/2010
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